Healthcare Provider Details
I. General information
NPI: 1538379326
Provider Name (Legal Business Name): ALEXANDER M HAMLING MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/23/2007
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1909 214TH ST SE SUITE #300
BOTHELL WA
98021-4412
US
IV. Provider business mailing address
12726 12TH AVE NE
SEATTLE WA
98125-4013
US
V. Phone/Fax
- Phone: 425-412-7200
- Fax: 425-412-7348
- Phone: 412-215-0318
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 35.092850 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | 57011966 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | MD60088380 |
| License Number State | WA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: